Koçoğlu Barlas Ülkem, Akçay Nihal, Telhan Leyla, Kanğın Murat, Umur Özge, Çıtak Agop, Tuğrul Hazal Ceren, Erdoğan Seher, Menentoğlu Mehmet Emin, Şevketoğlu Esra, Duyu Muhterem, Boydağ Güvenç Kübra, Can Yaşar Yusuf, Türkoğlu Batuhan
Department of Pediatrics, Pediatric Intensivist, Istanbul Medeniyet University Faculty of Medicine, Goztepe Prof Dr Suleyman Yalcın City Hospital, Pediatric Intensive Care Unit, İstanbul, Türkiye.
Department of Pediatrics, University of Health Sciences Türkiye, Kanuni Sultan Suleyman Training and Research Hospital, Pediatric Intensive Care Unit, İstanbul, Türkiye.
Turk Arch Pediatr. 2024 Sep 2;59(5):494-500. doi: 10.5152/TurkArchPediatr.2024.24149.
The aim of the study was to evaluate respiratory syncytial virus (RSV) infections in cases followed in the pediatric intensive care unit (PICU). The study was designed as a prospective cohort in 6 PICUs. There were 3 groups: only RSV (+), RSV (v+) who were positive for another viral agent(s) in addition to RSV, and RSV (b+) who were positive for a bacterial agent(s) in addition to RSV. A total of 119 cases were included in the study, 67 (56.3%) of whom were male. The RSV (+) group had a lower pH compared to the other groups and a higher rate of acute bronc hiolitis/bronchitis diagnoses compared to the RSV (v+) group. The RSV (v+) group had higher bicarbonate levels, higher creatinine levels, longer hospital stays, and higher Pediatric Risk of Mortality-3 scores (PRISM-3) compared to the RSV (+) group. Cases with RSV (b+) were younger and also had lower body weight compared to the other groups. Furthermore, the RSV (b+) group had higher C-reactive protein and Procalcitonin (PCT) levels and higher rates of High Flow Nasal Cannula-Oxygen Therapy (HFNC-OT) use. Multiple linear regression analysis revealed that PRISM-3 score, PCT levels, Pediatric Acute Respiratory Distress Syndrome diagnoses, inhaled steroid use, chronic illness status, and heart rate on admission were associated with the length of stay in the PICU. High flow nasal cannula-oxygen therapy continues to be the most frequently preferred respiratory support method in RSV infections. Viral infections accompanying RSV can increase the severity of the disease.
本研究的目的是评估在儿科重症监护病房(PICU)接受治疗的病例中的呼吸道合胞病毒(RSV)感染情况。该研究被设计为一项针对6个PICU的前瞻性队列研究。共分为3组:仅RSV阳性(+)组、除RSV外还对另一种病毒病原体呈阳性的RSV(v+)组,以及除RSV外还对一种细菌病原体呈阳性的RSV(b+)组。该研究共纳入119例病例,其中67例(56.3%)为男性。与其他组相比,RSV(+)组的pH值较低,与RSV(v+)组相比,急性细支气管炎/支气管炎的诊断率较高。与RSV(+)组相比,RSV(v+)组的碳酸氢盐水平更高、肌酐水平更高、住院时间更长、儿科死亡风险-3评分(PRISM-3)更高。与其他组相比,RSV(b+)组的病例年龄更小且体重更低。此外,RSV(b+)组的C反应蛋白和降钙素原(PCT)水平更高,高流量鼻导管吸氧治疗(HFNC-OT)的使用率更高。多元线性回归分析显示,PRISM-3评分、PCT水平、小儿急性呼吸窘迫综合征诊断、吸入性类固醇的使用、慢性病状态以及入院时的心率与PICU住院时间相关。高流量鼻导管吸氧治疗仍然是RSV感染中最常用的呼吸支持方法。伴随RSV的病毒感染会增加疾病的严重程度。